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Nuts in the News 2012

The advancement of medical technology benefits us all. There’s no doubt that the development of less invasive surgical procedures and improvements in infectious disease management have saved countless lives. But, what’s sometimes lost in the noble quest for cutting edge therapies is the acknowledgement that non-technological approaches can save lives too. Using certain whole foods in a medicinal manner is one illustration. By that, I mean eating nutrient dense foods in a prescribed capacity – as though they were medications. I believe that the reason this is rarely endorsed is a lack of conviction about the impact that diet can play in objective medical outcomes. Fortunately, the evidence to support the integration of therapeutic foods into the current health care model is widely available for anyone who’s interested.

The December 2011 issue of the Journal of the American College of Nutrition reports that those who regularly eat nuts are less likely to experience elevated blood sugar and insulin, heart disease risk factors and overweight than those who do not. Heart disease, metabolic syndrome, obesity and type-2 diabetes top the list of modifiable conditions that can and should be addressed using dietary and lifestyle measures. However, few physicians currently advise patients to eat an ounce or two of almonds, pecans or walnuts to address these well established health threats.

Other prevalent conditions ranging from cancer to depression and even age-related cognitive decline may likewise respond to “nut therapy”. Of late, several reviews and studies have shed light on the chemical make up of various tree nuts. The findings reveal that nuts are potent reservoirs of bioactive compounds such as phytosterols and polyphenols which possess anti-cancer properties. In fact, one investigation conducted at the University of Scranton, PA determined that, on average, about 19% of the total dietary polyphenols, potent antioxidants, come from nuts. What’s more, a fascinating study appearing in the September 2011 issue of Nutritional Neuroscience discovered that a diet rich in nuts is capable of increasing the level of brain-derived neurotrophic factor (BDNF) – a protein that is vital for the creation and survival of neurons and plays an important role in learning and memory. Lower levels of BDNF have also been reported in those living with chronic depression. It’s currently unknown how nuts influence BDNF levels. However, one theory is that the naturally occurring magnesium present in nuts may encourage greater BDNF expression and improved communication between neurons.

In closing, I want to address a few fallacies that discourage some from eating nuts as part of a daily diet. There is an unjustified concern that moderate nut consumption contributes to heart disease and obesity. According to some authorities, nuts are simply too high in calories and fat to be good for you. On the heart disease front, this idea is promoted by advocates of very low fat diets. The fact that virtually every study evaluating this hypothesis has determined the opposite to be true doesn’t seem to influence this position. In my opinion, it clearly should. The same goes for the potential of nuts to contribute to weight gain. Study after study indicates that moderate nut consumption (1 to 2 ounces daily) doesn’t affect weight in any meaningful way. If anything, some intervention trials have found non-significant weight loss in those who replace other snacks with tree nuts, such as pistachios. It should also be noted that nuts tend to satisfy hunger more than other commonly recommended snacks which are higher in carbohydrates and lower in fat. This alone can be a valuable tool in many cardiovascular and weight management programs which require adherence to a therapeutic diet.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

I don’t know if you’re still responding to comments re: this post, but here goes:

1) Do you have an opinion re: the notion that nuts are “bad for you” (and specifically in regard to cardiovascular disease) because they’re too high in Omega 6s?

2) And although technically not “nuts,” do you have an opinion on peanuts and peanut butter (the freshly ground, no salt, no hydrogenated fats kind)? Is ground peanut butter more likely to oxidized. . .and, if so, does it matter?

Many nuts contain a fair share of omega-6 fatty acids. However, their overall composition (fiber, minerals, monounsaturated fats, phytochemcials, etc.) almost always tips them in favor of cardiovascular health. The same goes with peanuts and peanut butter. A few relevant links:

Prospective Evaluation of the Association of Nut/Peanut Consumption With Total and Cause-Specific Mortality

Importance: High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status.

Objective: To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China.

Design, Setting, and Participants: Three large cohorts were evaluated in the study. One included 71 764 US residents of African and European descent, primarily of low SES, who were participants in the Southern Community Cohort Study (SCCS) in the southeastern United States (March 2002 to September 2009), and the other 2 cohorts included 134 265 participants in the Shanghai Women’s Health Study (SWHS) (December 1996 to May 2000) and the Shanghai Men’s Health Study (SMHS) (January 2002 to September 2006) in Shanghai, China. Self-reported nut consumption in the SCCS (approximately 50% were peanuts) and peanut-only consumption in the SMHS/SWHS were assessed using validated food frequency questionnaires.

Main Outcomes and Measures: Deaths were ascertained through linkage with the National Death Index and Social Security Administration mortality files in the SCCS and annual linkage with the Shanghai Vital Statistics Registry and by biennial home visits in the SWHS/SMHS. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs.

Results: With a median follow-up of 5.4 years in the SCCS, 6.5 years in the SMHS, and 12.2 years in the SWHS, 14 440 deaths were identified. More than half of the women in the SCCS were ever smokers compared with only 2.8% in the SWHS. The ever-smoking rate for men was 77.1% in the SCCS and 69.6% in the SMHS. Nut intake was inversely associated with risk of total mortality in all 3 cohorts (all P

Conclusions and Relevance: Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health.

Diet quality improves for parents and children when almonds are incorporated into their daily diet: a randomized, crossover study.

The health benefits of nuts may, in part, be due to the fiber that provides substrate for the maintenance of a healthy and diverse microbiota. We hypothesized that consuming almonds would benefit immune status through improving diet quality and modulation of microbiota composition in parents and their children, while improving gastrointestinal function. In a crossover trial, 29 parents (35 ± 0.6 years) and their children (n = 29; 4 ± 0.2 years; pairs) consumed 1.5 and 0.5 oz, respectively, of almonds and/or almond butter or control (no almonds) for 3 weeks followed by 4-week washouts. Parents completed daily questionnaires of stool frequency and compliance with nut intake. The Gastrointestinal Symptom Response Scale was administered weekly. Participants provided stools for microbiota analysis and saliva for secretory immunoglobulin A. Serum antioxidant/proinflammatory balance was determined in parents. From weekly dietary recalls (Automated Self-Administered 24-Hour Dietary Recall), nutrient and energy intake were assessed and Healthy Eating Index-2010 scores were calculated. Consuming almonds increased total Healthy Eating Index score from 53.7 ± 1.8 to 61.4 ± 1.4 (parents) and 53.7 ± 2.6 to 61.4 ± 2.2 (children; P < .001). Minimal changes in gastrointestinal symptoms and no change in stool frequency were noted with the almond intervention. Microbiota was stable at the phylum and family level, but genus-level changes occurred with nut intake, especially in children. No differences were observed for immune markers. Although higher intakes of almonds or longer interventions may be needed to demonstrate effects on immune status, a moderate intake of almonds improves diet quality in adults and their young children and modulates microbiota composition.

Be well!

JP

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